Apothagram
F eatured P roduct
®
PCCA T3 Sodium
Dilution™ (1:1000)
A MONTHLY PUBLICATION FROM PROFESSIONAL COMPOUNDING CENTERS OF AMERICA
PCCA #55-4250
JULY 2011
Congratulations to David Miller, RPh, PhD, of
Keystone Pharmacy in Grand Rapids, Mich.,
PCCA’s July Pharmacist of the Month.
David Miller, RPh, PhD
S tats :
• BS from Ferris State University in
1990; MS in Pharmaceutics from
University of Michigan in 1994; PhD
in Pharmaceutics from University of
Michigan in 1996, with an emphasis in
transdermal drug delivery, specializing
in iontophoresis
Compounding is a perfect fit for someone with a formulation development
background. When I first heard of the opportunity to join Keystone Pharmacy
as a compounding specialist, I was excited to have a chance to work on smaller
formulation development, focusing on one patient at a time. My partner and mentor,
Larry Curtis, RPh, encouraged me to come to Michigan for a visit. Afterwards, I
was so excited about the opportunity that compounding presented that I could not
wait to move from Salt Lake City back to Grand Rapids to begin my new career!
At Keystone Pharmacy, I face thrilling challenges that my team and I are forced
to tackle daily. Because of my basis in pharmaceutics, I have the physiochemical
background that is necessary to overcome most formulation difficulties, and the
insight into how to solve drug delivery challenges.
Favorite PCCA Formulas
I love pain management. I love the gratification that comes from helping a patient
alleviate their pain. My favorite formulas are Ketamine 10%, Gabapentin 6%,
Clonidine 0.2%, Lidocaine HCl 2% Topical Lipoderm® (PCCA Formula #9383), and
variations thereof. Typically at Keystone Pharmacy, we’ll add Amitriptyline 7% and
Ketoprofen 10% to the formulation.
It is my goal with pain management to help end the patient’s pain as expediently
• Nine years of compounding experience as possible. Typically, these patients are very difficult to treat. Their physicians have
tried all of the easy things with them; therefore, they frequently are in despair and
• Pharmacy prepares 113 compounds
feel hopeless. By using the “shotgun approach,” and hitting as many of the seven pain
per day
modulators as possible (sodium channel; opioid; GABA; glutamate and aspartate,
including AMPA and NMDA; epi/norepinephrine; and inflammatory, including prostaglandin-mediated and alpha agonist), it is
my opinion that we have the best chance of mitigating the patient’s pain and giving them back their quality of life.
Compounding Success Stories
At Keystone Pharmacy, we’ve been on the receiving end of many stories with positive outcomes, which continually add to the
reasons of why I compound. Our first story is about Steve, a motorcycle crash victim who had severe neuropathic pain in his legs
as a result of his injuries. He hadn’t slept in months because of the pain, and he often felt desperate and hopeless. The pain clinic
was at their wits’ end with Steve, but I convinced the doctor to allow me to try a pain
Table of Contents
cream using the “shotgun approach” mentioned above. Steve was skeptical, but picked up
Page
his cream the next morning and applied it three times that day. The following morning,
Article
I called Steve to follow up. He reported that he was nearly pain-free, and slept for eight
Technician of the Month
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hours the previous night! He literally was in tears, overcome by the relief and hope that
Consultant's Corner
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these compounded formulations afforded.
PK Soft ware
Our second story features Violet, an 89-year-old terminal cancer patient. Violet had
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collapsed veins, muscle wasting, could not take anything by mouth, had a rectal fistula,
Dates to Remember/
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and her integument (skin) was degrading. The doctors couldn’t think of a practical
Ask Artie
way to administer morphine, or any other opioid, to relieve her pain. I suggested using
Formula Spotlight/
a Morphine 10 mg/3 mL Solution (modified PCCA Formula #3253) in a nebulizer,
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Product of the Month
allowing Violet to inhale her pain relief. Her physician later reported that Violet received
August Events
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adequate pain relief as a result of the nebulized formulation, and that she passed away
pain-free.
In the News
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PCCA PHARMACIST OF THE MONTH
D AV I D M I L L E R , R P h , P h D
Congratulations to Bea F. Mendoza, CPhT, of Thrifty Health &
Compounding Pharmacy in Humble, Texas,
PCCA’s July Technician of the Month.
The pharmacy is owned by Terry Mielke, RPh.
PCCA TECHNICIAN OF THE MONTH
B E A F. M E N D O Z A , C P h T
Training and Education
I started my pharmacy career while I was still in the Army, obtaining training as a
pharmacy technician. After four years, I was hired on at Texas Children’s Hospital
Pharmacy in the compounding department. Within this department, I primarily learned
how to do hospital compounding. Fortunately, because of my compounding experience
and my eye for detail, I was able to land a position as an Investigational Drugs Service
Pharmacy Technician.
As an Investigational Drugs Service Pharmacy Technician, I had the privilege to do a
portion of my work with NASA. I was given the opportunity to prepare sterile, stable isotopes
for several NASA space flight studies that were being conducted on the astronauts and
cosmonauts. Of these, the most memorable was STS-90, which launched John Glenn back
into space.
After working at Texas Children’s Hospital for 11 years, I decided it was time for a new
experience. I began working at Thrifty Health & Compounding Pharmacy, and have now
been here for nine and a half years. Because of Thrifty Health & Compounding Pharmacy,
I’ve learned to love patient interactions and questions. I also love the curiosity from our
doctors, patients, and other pharmacists. Prior to this job, these were things that I didn’t have
the opportunity to experience as much. I’m very glad that at Thrifty Health & Compounding
Pharmacy I get to have these positive experiences, and I wish I could be even more involved
with my patients.
Compounding Success Story
One of the things I love about my job is the close relationships that we are able to have with
our patients. They rely on us to take care of their needs. One example of someone we were able
to help was Ms. Bettie. We helped her through the use of PCCA Formula #9448, Ketoprofen
10% Topical Lipoderm® (PCCA FormulaPlus™ BUD Study).
Ms. Bettie originally had arthritis in her hands, but thanks to the
ketoprofen in the Lipoderm cream, she saw improvements and
relief. She is so grateful to us because she now can do everyday
things with ease again.
Bea F. Mendoza, CPhT
S tats :
•
•
•
•
•
Received her training in the
Army
At Thrifty Health &
Compounding Pharmacy
for nine and a half years.
Received her non-sterile
compounding training from
PCCA in October 2001.
Attended PCCA’s Aseptic
Compounding Technique
Course in November 2002.
“My favorite piece of lab
equipment is the Jaansun®
Capsule Machine Vibrator.
It cuts my capsule prep
time in half while helping
to accurately fill capsules.
The dishwasher is a close
second!”
Favorite Formulas
My favorite formulas are the hormones for our menopausal patients. The patients, as well as
their families, are always so thrilled and grateful to have a product that can make their lives more
comfortable. I also find satisfaction when helping pets, especially dogs with epilepsy. When you
have seen a pet have a seizure, and you know that potassium bromide can prevent it, such as PCCA
Formula #4523, Potassium Bromide 350 mg/mL Oral Solution (Vet), preparing their prescriptions is very rewarding. The same
satisfaction goes for the pediatric prescriptions we compound. There is nothing better than knowing that you are helping a child in need!
“This Works for Me” By: David Miller, RPh, PhD
Advice for a new compounder:
1. Obtain a mentor and listen to their advice. A mentor can help to guide you down the right path to ensure your
patients receive the best care.
2. Surround yourself with a dedicated and talented team who has a passion for helping people.
3. Always put the needs of your patients first. By putting the needs of your patients first, and working to solve their
problems to the best of your ability, your business will f lourish, and you will be happier as you reap the love and
respect that comes with those efforts.
4. Build your practice on safety.
5. Never stop learning!
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